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Preventing and responding to gender-based violence in conflict-affected areas of Ukraine

November 27, 2023

A staff member (right) provides a consultation to a client at Brave&Safe, a response and care unit run by HealthRight International and FHI 360 in Dnipro. Response and care units support survivors of gender-based violence in areas of Ukraine close to the front lines or where active conflict is occurring.

A staff member (right) provides a consultation to a client at Brave&Safe, a response and care unit run by HealthRight International and FHI 360 in Dnipro. Response and care units support survivors of gender-based violence in areas of Ukraine close to the front lines or where active conflict is occurring. Photo credit: HealthRight International for FHI 360

Times of war can compound the factors that lead to gender-based violence (GBV) — while also silencing people who need help the most.

“Ukrainian women have found themselves in a very hard situation,” says Alla Demycheva, gender-based violence officer at FHI 360.

In the first five months of 2023, reported cases of domestic violence increased by 51% compared to the same period in 2022. And many instances of violence go unreported.

“Many women believe that it is not the right time to raise the issue of gender-based violence and ask for help,” says Demycheva. “When people are fighting and dying, it feels like there are other, more serious challenges for law enforcement.”

But there is never a time when it is OK to experience violence — and in Ukraine, many factors are increasing people’s likelihood of experiencing GBV. During the conflict, schools have closed, forcing women to leave their jobs and stay home to care for children. And people are contending with “constant sounds of air raid alarms and explosions, a high inflation rate, reduced national funding [for GBV support], and general tension,” says Demycheva. 

In Ukraine, FHI 360 is helping prevent GBV and sexual exploitation, and we’re assisting survivors. Our Ukraine Humanitarian Assistance Response Program (UHARP II), which is funded by the Bureau for Humanitarian Assistance at the U.S. Agency for International Development (USAID), aims to improve access to quality health care, mental health services, and protection support — including psychosocial and GBV support services — for conflict-affected populations in south and east Ukraine.

Raising awareness and supporting survivors

Alla Demycheva, gender-based violence officer at FHI 360, conducts a session to raise awareness about preventing and responding to gender-based violence. This session was held for social workers in a small settlement within the southeastern Ukrainian oblast of Dnipropetrovsk, which was previously occupied by Russian forces in 2022.

Alla Demycheva, gender-based violence officer at FHI 360, conducts a session to raise awareness about preventing and responding to gender-based violence. This session was held for social workers in a small settlement within the southeastern Ukrainian oblast of Dnipropetrovsk, which was previously occupied by Russian forces in 2022. Photo credit: Osmanova Viktoriia for FHI 360

As part of the UHARP II project, FHI 360 is partnering with HealthRight International, an organization that expands access to quality health systems for marginalized communities.

“Our cooperation has allowed us to create an entirely new model that has not been tried at the primary level of health care in Ukraine,” says Vira Goncharuk, technical program advisor at HealthRight. “To me, this is our greatest achievement: We saw the need for these services, and we created them.”

FHI 360 focuses on raising awareness of GBV by conducting trainings for social workers, state officials, teachers, police officers and health workers from various communities so they can prevent and respond to cases of violence.

The FHI 360 team develops the trainings’ core messages, then tailors those messages depending on the audience’s needs and their role in preventing GBV. For example, their messages for teachers at colleges and technical schools focus on how schools can reinforce harmful gender norms and inequality.

“I offer to go with them through the school hallways and have a good look around,” says Demycheva. “There are posters of famous mathematicians and travelers. Are any of them women? No. There are posters about safety and security rules — and there are only boys on those posters.”

Meanwhile, HealthRight focuses on GBV response. While state agencies often require people to submit identifying documentation to obtain support, HealthRight does not restrict people from receiving services due to a lack of documents. “We simply start with a conversation,” says Goncharuk.

The organization supports survivors through two types of care units: mobile units and units that are located within primary health care centers. All the units are in six regions in southern and eastern Ukraine, either close to the front lines or where active conflict is occurring.

“Our model provides services as close as possible to the person who needs help,” says Goncharuk.

HealthRight provides comprehensive support to survivors of GBV by employing a family doctor, lawyer, social worker and psychologist in each unit. The organization also collaborates with other entities, such as shelters, civil society organizations and state-run support systems, building on what is available regionally.

“Our partnership doesn’t mean that we don’t overlap or that one of us can’t do other things,” says Demycheva. “The distinct focuses of our organizations make a great combination.”

Building on trusted resources

Vira Goncharuk, technical program advisor at HealthRight International, conducts a training for medical staff in Kyiv about clinical management of rape survivors. Photo credit: HealthRight International for FHI 360

Vira Goncharuk, technical program advisor at HealthRight International, conducts a training for medical staff in Kyiv about clinical management of rape survivors. Photo credit: HealthRight International for FHI 360

For those who fled their homes in the conflict, it can be difficult to know who to turn to. “But the level of trust in family doctors remains very high,” says Goncharuk.

Family doctors don’t always know how to identify cases of violence, or they might be unfamiliar with protocols. Furthermore, in many locations, family doctors are overstretched due to the increase of health care needs from displaced populations. So FHI 360 and HealthRight offer family doctors practical information that introduces a comprehensive approach to help survivors of GBV, including how best to make referrals to relevant support.

One of the partnership’s goals, says Demycheva, was “to make the family doctor an effective entry point to the caring system.” Still, it takes time for people to feel comfortable sharing their experiences.

“We have found that in Ukraine, a person will share information about a case of violence in two situations,” says Goncharuk. “The first is when they trust the person they’re talking to. The second is when the situation is threatening them or their family’s life and health. Then they will share the information even when they don’t trust the receiver.”

A need for greater support

The conflict in Ukraine will soon enter its third year. As cases of gender-based violence soar, Demycheva notes that greater support is needed. “We don’t have enough state-run services to help women get to a safe place,” she says. FHI 360 and HealthRight’s partnership is designed to supplement these overstretched services. 

And men may benefit from psychosocial support after experiencing violence in conflict. Without targeted support, the constant violence of the battlefield can become internalized, and “returning to normal, peaceful life can be hard,” says Demycheva. 

For Goncharuk, continuing to raise awareness about GBV is key. “Now that we are at war,” she says, “we do not speak about gender violence much at all.”  

But in doing this work, Demycheva adds, “it’s very important not to remain indifferent … [because] we can save somebody’s life.”